Provider Demographics
NPI:1851694061
Name:TODD GALUSHA DC PC
Entity Type:Organization
Organization Name:TODD GALUSHA DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:GALUSHA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:585-454-1720
Mailing Address - Street 1:185 SAINT PAUL ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14604-1125
Mailing Address - Country:US
Mailing Address - Phone:585-454-1720
Mailing Address - Fax:
Practice Address - Street 1:185 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14604-1125
Practice Address - Country:US
Practice Address - Phone:585-454-1720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-09
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010283111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCC8461Medicare PIN